A previously healthy 11-year-old girl with behavioural disturbances, desquamation of the skin and loss of teeth

An 11-year-old girl was admitted with backpain, weight loss, fatigue and behavioural disturbances, starting seven weeks before admission. Physical examination showed acrodynia, tremor, cachexia, hypertension and extensive gingival ulceration. Routine laboratory tests were normal, except for a CRP of...

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Bibliographic Details
Published in:European journal of pediatrics 2009-04, Vol.168 (4), p.509-511
Main Authors: van der Linde, A. A. A., Lewiszong-Rutjens, C. A. W., Verrips, A., Gerrits, G. P. J. M.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Borrelia
Chelating Agents - therapeutic use
Child
Diagnosis, Differential
Female
General aspects
Human immunodeficiency virus
Humans
Medical sciences
Medicine
Medicine & Public Health
Mental Disorders - chemically induced
Mental Disorders - diagnosis
Mercury - blood
Mercury Poisoning - blood
Mercury Poisoning - diagnosis
Mercury Poisoning - drug therapy
Pediatrics
Skin Diseases - chemically induced
Skin Diseases - diagnosis
Tooth Loss - chemically induced
Tooth Loss - diagnosis
Unithiol - therapeutic use
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Summary:An 11-year-old girl was admitted with backpain, weight loss, fatigue and behavioural disturbances, starting seven weeks before admission. Physical examination showed acrodynia, tremor, cachexia, hypertension and extensive gingival ulceration. Routine laboratory tests were normal, except for a CRP of 98 mg/l. Screening tests for recreational drugs as well as antibody assays for HIV, hepatitis B and borrelia burgdorferia were negative. Chest X-ray, brain CAT and MRI scan were all normal. Lumbar puncture didn’t show any abnormalities. Eventually a 24-hour urine test confirmed the diagnosis that was suspected by further questioning.
ISSN:0340-6199
1432-1076
DOI:10.1007/s00431-008-0851-6